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23�C25 As is the case for BMD variation, much of the variation in ALP level remains unexplained. While common ALPL sequence variations have been linked to circulating ALP levels in population samples, loss of function mutations in the ALPL gene also contribute to hypophosphatasia (HPP; OMIM buy Doxorubicin 241500, 241510, 146300), a rare inborn error of mineral metabolism.26 The disease is characterized by a global deficiency of ALP activity, inadequate hard tissue mineralization, and fractures. The clinical severity of HPP is widely variable and ranges from death in utero to mild dental complications. Mutation analyses of HPP subjects have identified over 200 mutations, of which approximately 80% are missense (for a complete listing the reader is referred to a database maintained by the SESEP Laboratory and the Human Molecular Genetics laboratory of the University of Versailles-Saint MK-1775 Quentin, Yvelines, France http://www.sesep.uvsq.fr/03_hypo_mutations.php).27 In virtually every case, HPP appears to be a consequence of either a homozygous point mutation or a compound heterozygous genetic condition. The wide range of mutations is likely responsible for the variability in clinical presentation and disease severity. The combined evidence from laboratory mouse experiments and clinical studies of patients with HPP led us to hypothesize that low-frequency coding variants in ALPL may also affect BMD in humans unaffected by HPP. For the studies reported here, we employed an interdisciplinary approach incorporating data from both mouse models and human studies. We aimed to discover coding variants in ALPL (among men in a population-based cohort) and its murine homolog, Alpl, and to test associations with serum ALP and BMD. In laboratory mice, we identified a coding sequence variant selleck chemical (L324P) in Alpl that was associated with reduced serum ALP, BMD, and bone strength in a panel of mouse strains. In elderly men with reduced serum ALP activity, we identified 25 single-nucleotide coding variants in ALPL, 22 of which had minor allele frequency (MAF)?<?1%. Seven of these variants can be considered novel because they have not been recorded in the hypophosphatasia or other single-nucleotide polymorphism (SNP) databases including the 1000 Genomes Project. We discovered that subjects bearing rare nonsynonymous coding variants in ALPL exhibit reduced mean serum ALP levels, elevated serum phosphate levels, and lower BMD. Thus, we describe an association between rare nonsynonymous variants in the gene encoding ALP with circulating enzyme activity and bone density in both mice and humans.</div>